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Fungal endophthalmitis

INTRODUCTION

Fungal endophthalmitis due to yeasts (eg, Candida albicans) is very different from that due to molds (eg, Aspergillus or Fusarium). While Candida endophthalmitis is usually treated successfully, mold endophthalmitis often results in the loss of vision.

The clinical features, diagnosis, and treatment of both types of fungal endophthalmitis will be reviewed here. Bacterial endophthalmitis and Candida infections are presented separately. Fusarium keratitis is discussed elsewhere. (See "Bacterial endophthalmitis" and "Overview of Candida infections" and "Fusarium infection".)

CANDIDA ENDOPHTHALMITIS

Candida species are a common cause of fungal endophthalmitis. This infection arises in two discrete ways:

  • The exogenous form follows trauma or a surgical procedure on the eye with direct inoculation of the organism into the anterior chamber.
  • The endogenous form follows candidemia with hematogenous seeding of the retina and choroid.

Regardless of the route of infection, if untreated, both forms progress to endophthalmitis, in which the vitreous is infected, and can result in loss of sight.
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